ACTH protects against glucocorticoid-induced osteonecrosis of bone

Proc Natl Acad Sci U S A. 2010 May 11;107(19):8782-7. doi: 10.1073/pnas.0912176107. Epub 2010 Apr 26.

Abstract

We report that adrenocorticotropic hormone (ACTH) protects against osteonecrosis of the femoral head induced by depot methylprednisolone acetate (depomedrol). This therapeutic response likely arises from enhanced osteoblastic support and the stimulation of VEGF by ACTH; the latter is largely responsible for maintaining the fine vascular network that surrounds highly remodeling bone. We suggest examining the efficacy of ACTH in preventing human osteonecrosis, a devastating complication of glucocorticoid therapy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • 3T3 Cells
  • Adrenocorticotropic Hormone / pharmacology
  • Adrenocorticotropic Hormone / therapeutic use*
  • Animals
  • Apoptosis / drug effects
  • Cell Differentiation / drug effects
  • Cytoprotection / drug effects
  • Female
  • Femur / drug effects
  • Femur / pathology*
  • Glucocorticoids / adverse effects*
  • Humans
  • Mice
  • Osteoblasts / drug effects
  • Osteoblasts / metabolism
  • Osteoblasts / pathology
  • Osteoclasts / drug effects
  • Osteoclasts / metabolism
  • Osteoclasts / pathology
  • Osteonecrosis / chemically induced*
  • Osteonecrosis / drug therapy*
  • Osteonecrosis / prevention & control
  • Protective Agents / pharmacology
  • Protective Agents / therapeutic use*
  • Rabbits
  • Vascular Endothelial Growth Factor A / biosynthesis

Substances

  • Glucocorticoids
  • Protective Agents
  • Vascular Endothelial Growth Factor A
  • Adrenocorticotropic Hormone